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Referendum need pitched to board
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MONROE - Even if Green County closed Pleasant View Nursing Home tomorrow the county's financial responsibilities to the patients would not go away, Green County Board of Supervisors member Harvey Mandel told the county board Tuesday.

"If you go through the whole scenario of the nursing home you see that 70 percent of the people there are our responsibility," Mandel said.

The county board learned the county's Finance and Accounting Committee will finalize wording for a referendum Friday and then present the measure to the full board at a special meeting Aug. 25.

If the board votes to hold a referendum it will go before the voters Oct. 6.

Green County Clerk Mike Doyle, when asked by a board member what the county would do in the event the referendum fails, said the board would have to look at cuts in every county department.

Mandel told the board the nursing home's projected financial deficit of at least $1 million next year is a result of the state's decision to keep some of the federal money meant for the nursing home.

In 2008, the nursing home had a deficit of about $900,000.

"The state uses the money it should send to the county for other things," he said. "Not that what they spend it on isn't important but it hurts the county."

The board listened to discussion at its monthly meeting about a possible referendum to exceed the 2010 budget levy limit of 3 percent to help pay for the nursing home's deficit.

Mandel said initial estimates show that a five-year referendum of $500,000 a year would cost the owner of a home valued at $150,000 about $28.59 per year. A $1 million dollar referendum would cost the homeowner $57.17.

"All of us here are taxpayers. I know this isn't something we look forward to doing," he said.

Mandel said he understands that it might be difficult for people who have lost their jobs to accept a referendum that will raise their taxes.

"We don't want to do this but we don't have any other choice," he said.

Green County Pleasant View Nursing Home Committee member and county board member Herb Hanson said the nursing home is needed.

"The for-profit nursing homes turn away people like those at Pleasant View," he said. "Pleasant View fills an important need for the county. Every one of us know someone who has been there."

Hanson said the nursing home and its employees also spend money in local communities and that is important to Green County's economy.

The board learned there are ways for the county to make some money from the nursing home by providing physical therapy and rehabilitation programs for patients on an out-patient basis. How much money the county could recoup through those programs isn't known.

Pleasant view administrator Terry Nelson said the nursing home's goal is to make a profit.

"That won't happen in six months but it's something we hope to accomplish,' she said.

The board was told that if there came a time when the nursing home didn't need the money from the referendum the money wouldn't be collected. The referendum money could only be used for the nursing home, board chairman Art Carter said.

Board members listened without much discussion as Mandel and Hanson explained the home's financial problems.

They also learned that the budget shortfall for the nursing home would have to be made up even if the referendum fails.

There are no plans to close the nursing home any time soon. It will continue to operate next year.

Tuesday's meeting allowed the entire board to hear about the nursing home and the possible referendum.

It wasn't the first time the county board was notified about Pleasant View's financial concerns.

Mandel told the board in November, when it discussed the 2009 budget that the nursing home lost money and would lose money in 2009.

At the time it was hoped the state would be able to provide the funding it owed the nursing home. The state Legislature decided to keep some of the federal money ordinarily sent to the nursing home to help cover its Medicaid Trust Fund deficits.

Green County isn't alone in its financial problems with a county owned nursing home.

In January and February, the Pleasant View Nursing Home Committee and the county board learned from Brian Schoeneck, financial services director for the Wisconsin Association of Homes and Services for the Aging, that county-operated nursing homes across the state faced financial problems due to the state budget.

Schoeneck said county nursing homes have more Medicaid residents than private nursing homes. Private nursing homes take Medicare patients or patients that are rehabilitating from surgery. That allows private homes to have higher patient turnover rates, enabling them to make more money, he said.

About 70 percent of Pleasant View's residents receive Medicare. About 20 percent of the nursing home's residents are diagnosed with dementia, have complex medical needs and are Medicaid residents other nursing homes won't accept.

If the county decided to close the nursing home, it still would be required by the state to provide housing for some residents. The cost for the patients would be transferred to Green County Human Services. It's estimated the cost to house patients in other facilities in other counties could be as much as $3.8 million a year.

The state's 3 percent tax levy limit wouldn't cover the increased costs to Green County Human Services.

In addition, Green County might have to send residents to other state homes that are farther away. As other counties find themselves wrestling with budget issues, residents from other counties often aren't accepted.